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The Truth About the Ketogenic Diet

By Jodi Nishida, PharmD of The Keto Prescription Clinic

Expertise: Dr. of Pharmacy with certifications in Ketogenic nutrition, cardiovascular disease management, pharmacogenomics, and medication management


  • Keto is Low Carb, Moderate Protein, High Healthy Fat

  • Keto is not the Atkins Diet. Atkins is HIGH protein. Keto is Moderate protein

  • A well-formulated keto plan does not incorporate high quantities of the following: packaged “keto” snacks, pork rinds, cured meats like salami, animal fat from foods like bacon, canned meat like spam or Vienna sausage, cheese or dairy

I first started researching the ketogenic diet over 4 years ago. Back then, I was about 4 years behind the early-adopters. There was a lot of speculation about it being a “fad diet,” another diet that’ll have its hay day then disappear. For those of us who really did the research, we knew this was no fad. Keto is one of the biggest healthcare solutions to surface in decades.

Where It All Started

Since around the 1960’s, we’ve been told to eat a low-fat diet. Low-fat was deemed to be heart-healthy and to help prevent heart attacks and strokes. Our food pyramid and nutritional guidelines were designed around the low-fat recommendations and the food industry followed suit. If low-fat was right and true, why then is the United States one of the most obese countries in the world? As of 2018, America’s obesity rate was 42%. That’s almost half the country (two years ago) and sadly, a growing percentage of that is in children. One decade at a time, as we ate less fat, we started eating more sugar. Let me quickly list some of the foods that turn into sugar in the body: rice, pasta and noodles, potatoes, bread, fruit, baked goods, chips, oatmeal, quinoa, grains, sugary drinks, corn and popcorn, and all desserts. Sugar raises insulin levels in the bloodstream. Insulin signals the body to store fat. This is the hormone feedback system of weight gain in a nutshell.

We Love Our Grindz

For the Hawaii people out there, two scoops of rice and one scoop of macaroni salad turns into 40 teaspoons of sugar in the body. Pause for a minute and think of how many plate lunches you’ve consumed in your lifetime. Let me say it a different way. Would you ever tear open 40 packets of sugar and pour it down your throat? Most people would retort, “No way!” Yet, you’re doing the exact same thing when you eat a plate lunch. Convenience stores, fast-food chains, and packaged foods have only added to the problem. People fail to understand how much sugar they consume in an average day. Carbohydrates turn into sugar.

“Keto done correctly incorporates a variety of proteins, focuses on green, leafy vegetables that grow above ground, limited packaged or processed foods as much as possible, and incorporates small amounts of healthy fats...” - Dr. Jodi Nishida, The Keto Prescription

What Does the Medical Community Think?

Now that you understand food a little better, I can confidently tell you that America is running on sugar as its fuel source. But like a hybrid car, know that another fuel source exists called ketones. Ketones come from dietary fat and the fat on your body. The keto diet puts you in a state of fat-burning known as “ketosis.” Humans thrive on ketones and slowly die on sugar.

The medical community has yet to fully accept this. Part of the problem is that you have people on social media who consume large amounts of bacon, low quality cheese, pork rinds, salami, red meat every day, and minimal vegetables and call it “keto.” People with no medical degree dispense medical and nutritional advice and doctors see it. Social media and the vast degree of information on YouTube can truly be a curse or blessing. It’s become increasingly important to understand that there are many ways to do keto wrong. I teach my patients to do “clean keto.”

Did You Say "Clean Keto"?

Clean keto includes a variety of proteins, almost all vegetables, limited quantities of fruits with less sugar, and plant-based healthy fats over animal fat. Keto also needs to be tailored to individual patients based on their medical history. Patients with a history of kidney stones, gall bladder removal, heart conditions, or gout will all do keto slightly differently than each other and everyone else out there. Many people have ended up in the hospital by doing “dirty keto” or “lazy keto.” Please exercise caution. Keto done correctly incorporates a variety of proteins, focuses on green, leafy vegetables that grow above ground, limited packaged or processed foods as much as possible, and incorporates small amounts of healthy fats like avocados, extra-virgin olive oil, or pecans with every meal. Fat is dense so you don’t need a lot of it on your plate.

That is the 35,000 foot view of keto. Again when done correctly, it does wonders for health and weight loss. We’ve seen complete reversals of fatty liver, diabetes, arthritis, anxiety, migraines, and others in our medical practice. When you spend time educating patients and make it doable with regular food that can be found in a grocery store, you create a recipe for health and success. We are continually excited to partner with companies like Good Clean Foods Hawaii who offers low-carb, fresh-prepped options for our community.

May 2021 bring you true health and prosperity. Aloha!

Learn more about keto and the guest contributor at The Keto Prescription or continue the conversation with Jodi and her team on Instagram at @theketoprescription

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